Open AccessInterventional radiology-assisted transgastric endoscopic drainage of peripancreatic fluid collections
Author(s) -
Jeffrey Hawel,
H. McFadgen,
Richard D. Stewart,
Tarek H. El-Ghazaly,
Abdulrahim Alawashez,
James Ellsmere
Publication year - 2020
Publication title -
canadian journal of surgery
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.609
H-Index - 64
eISSN - 1488-2310
pISSN - 0008-428X
DOI - 10.1503/cjs.003019
Subject(s) - medicine , endoscopic ultrasound , radiology , endoscopy , pancreatitis , drainage , endoscopic ultrasonography , pancreatic pseudocyst , lumen (anatomy) , computed tomography , interventional radiology , surgery , ecology , biology
Peripancreatic fluid collections (PFCs) occur as a consequence of pancreatitis. Most PFCs resolve spontaneously, although 1%-2% persist and may require intervention. Conventional transluminal endoscopic drainage methods require the PFC to be bulging into the gastric wall; however, it is not uncommon for this to be absent. Imaging guidance for transluminal endoscopic PFC drainage allows the endoscopist to localize nonbulging pseudocysts that cannot be localized using endoscopy alone, to identify and avoid vascular structures between the cyst and the gastric lumen, and to reveal solid or necrotic components within the pseudocyst cavity. Although endoscopic ultrasound (EUS) has been used to meet this need, timely access to therapeutic EUS remains a limiting factor at many centres. We report our technique and experience performing transgastric endoscopic drainage of PFCs under computed tomography (CT) interventional radiology guidance.